PPS Rate
Effective for dates of service on and after January 1, 2003, the procedure codes listed in this manual, the Child Health Services (EPSDT) provider manual and the ARKids First-B Provider Manual (with the exception of the FQHC encounter procedure code and the telemedicine procedure code) will be initially reimbursed in accordance with the Arkansas Medicaid fee schedule, at the lesser of the billed charge or the Medicaid maximum allowable fee.
The telemedicine procedure code and procedure codes for ancillary services, except for family planning-related laboratory procedures listed in this manual, will be denied.
Arkansas Medicaid initially reimburses FQHCs for some services reported by CPT or HCPCS procedure codes other than the FQHC encounter code. They are later rate-settled as encounters in the same manner as other ambulatory services are rate-settled. See Section 260.000 for procedure codes and billing information.
- Effective for dates of service on and after January 1, 2003, the procedure codes listed in this manual, the Child Health Services (EPSDT) provider manual and the ARKids First-B Provider Manual (with the exception of the FQHC encounter procedure code and the telemedicine procedure code) will be initially reimbursed in accordance with the Arkansas Medicaid fee schedule, at the lesser of the billed charge or the Medicaid maximum allowable fee.
- The telemedicine procedure code and procedure codes for ancillary services, except for family planning-related laboratory procedures listed in this manual, will be denied.
- Except for ancillary services (lab, X-ray and machine tests), FQHC providers may not bill Medicaid with procedure codes that are not listed in this provider manual, the Child Health Services (EPSDT) provider manual and the ARKids First-B Provider Manual.